Clinical significance of ASCUS and ASC-H cytological abnormalities: a six-year experience at a single center.

BACKGROUND: To evaluate colposcopic biopsy results of patients with cervical cytological findings of atypical squamous cells of undetermined significance (ASC-US) and atypical squamous cells with high-grade lesions that cannot be excluded (ASC-H). MATERIALS AND METHODS: A retrospective evaluation of data from 358 patients, who had cervical cytological findings of ASC-US (n = 335) and ASC-H (n = 23), and had colposcopic assessments between 2005 and 2011. RESULTS: Cervical biopsy results of patients diagnosed with ASC-US cytology (n = 335) revealed cervical squamous cell carcinoma 0.9 % (n = 3) at biopsy, cervical intraepithelial neoplasia 3 (CIN 3) in 3.8 % (n = 13), cervical intraepithelial neoplasia 2 (CIN 2) in 1.1 % (n = 4), cervical intraepithelial neoplasia 1 (CIN 1) in 35.2% (n = 118), and benign lesions in 59 % (n = 197). Cervical biopsy results of patients diagnosed with ASC-H cytology (n = 23) revealed CIN 3 at biopsy in 39.3% (n = 9), CIN 2 in 21.7% (n = 5), CIN 1 in 26% (n = 6), carcinoma in situ in 8.7% (n = 2), and squamous cell cancer in one patient (4.3%). CONCLUSION: The cytological diagnosis of ASC-US may lead to the diagnosis of cervical intraepithelial lesion of higher grades as well as cervical cancer and should be evaluated by colposcopic cervical biopsy.

Is grand multiparity a risk factor for osteoporosis in postmenopausal women of lower socioeconomic status?

OBJECTIVE: We aimed to determine whether grand multiparity is a risk factor for osteoporosis among postmenopausal women of lower socioeconomic status. PATIENTS AND METHODS: We conducted a single center study between February 2012 and February 2013 on 50-60 year old postmenopausal women of lower socioeconomic status without a history of medical disease. Women with a body mass index (BMI) between 20 and 25 were included in the study. The grand multiparous group (group A) consisted of 38 women with 10 or more deliveries. Women with a history of three or fewer deliveries composed the control group (group B). Dual-energy x-ray absorptiometry was used to measure the bone mineral density (BMD) of the proximal femur neck and lumbar spine (L1-L4). RESULTS: The mean ages of groups A and B were found to be 54.3 ± 2.5 and 53.1 ± 2.7 years, respectively. Average parity in groups A and B was 11.1 ± 1.7 and 2.4 ± 0.7, respectively. Time since the onset of menopause was 3.6 ± 2.7 years in group A and 6.0 ± 2.9 in group B. The prevalence of osteoporosis was similar in both groups (71.1%-81.4%, p = 0.273). We found that grand multiparity was an ineffective indicator of either femoral or lumbar osteoporosis (p = 0.87 and p = 0.26), but osteoporosis five years after the onset of menopause was found to be significantly higher (p = 0.02). CONCLUSIONS: The duration of menopause is an independent risk factor of osteoporosis. However, the number of pregnancies is neither a determinant nor a protective factor for osteoporosis in postmenopausal women coming from a low socioeconomic background.

Evaluation of the histopathological diagnosis of patients preoperatively diagnosed with atypical endometrial hyperplasia after hysterectomy.

OBJECTIVE: To evaluate the patients diagnosed with atypical endometrial hyperplasia preoperatively, and compare preoperative and postoperative results. MATERIALS AND METHOD: We investigated the files of 58 patients diagnosed with atypical endometrial hyperplasia who were treated surgically after clinical evaluation. We compared sociodemographic diagnosis, preoperative and postoperative diagnosis. RESULTS: Mean-age of patients was 51.7. Obesity, diabetes mellitus, hypertension and infertility were seen, respectively, in eight cases (13.7%), 12 cases (20.6%), 19 cases (32.7%) and four cases (6.8%). While endometrial cancer was not found postoperatively in patients preoperatively diagnosed with simple atypical endometrial hyperplasia, we determined well differentiated endometrial adenocarcinoma in 44.7% of the patients. CONCLUSION: In the literature the probability of developing well differentiated endometrial cancer from complex atypical endometrial hyperplasia is 40-50%. All patients diagnosed with complex atypical hyperplasia should be evaluated preoperatively for well differentiated adenocarcinoma and undergo an appropriate surgical technique and staging.